Individual provider Active NPI

Kelsey Heffernan, APN

  • Family Nurse Practitioner
  • Camden, NJ
National Provider Identifier
1508354788
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00793700 Issued in NJ
Practice address
1 Cooper PLZ
Camden, NJ 08103
Phone
(800) 826-6737
NPI assigned
Apr 24, 2018
Last updated
Jul 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP018313 PA
Family Nurse Practitioner 363LF0000X 26NJ00793700 NJ Primary

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103

Mailing address

1 Federal St Ste Sw200
Camden, NJ 08103-1155
Phone (856) 356-4924

Other practice location 1

3 Cooper Plz Rm 513
Camden, NJ 08103-1438
Phone (856) 963-3715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180620002511 NJ Practitioner - Nurse Practitioner 7810242583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Cooper PLZ
Camden, NJ 08103-1461
Phone (856) 342-4192

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.83 of 100Reported as group
Quality
88.78
Promoting interoperability
99
Improvement activities
40
Cost
74.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP018313PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CMC Department of Medicine CurrentSince Jun 1, 2018 Accepting new patients
CMC Department of Medicine Group PA CurrentSince Jun 1, 2018 Accepting new patients

Locations

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

1 Federal St
Ste SW200
Camden, NJ 08103
Phone (856) 356-4920

3 Cooper Plz
Rm 104
Camden, NJ 08103
Phone (609) 963-6770

3 Cooper Plz
Rm 215
Camden, NJ 08103
Phone (856) 342-2439

3 Cooper Plz
Rm 311
Camden, NJ 08103
Phone (856) 342-2034

3 Cooper Plz
Rm 403
Camden, NJ 08103
Phone (856) 342-2270

3 Cooper Plz
Rm 513
Camden, NJ 08103
Phone (856) 963-3518

309 Bridgeboro Rd
Moorestown, NJ 08057
Phone (856) 439-2000

400 W Route 38
Moorestown, NJ 08057
Phone (856) 270-4000

Interoperability endpoints

  • Direct secure messaging: kheffernan36003@direct.cooperhealth.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1508354788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE SW200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031155",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "08103",
            "telephone_number": "800-826-6737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Cooper Plz Rm 513",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081031438",
            "country_code": "US",
            "telephone_number": "856-963-3715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEFFERNAN",
        "first_name": "KELSEY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018313",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00793700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.